Ahmed Bouanani, described by Anna Della Subin as an enigma, was a North African filmmaker, poet, and novelist. Born in Casablanca, Morocco in 1938, Bouanani was inspired by the drive to build a national culture following the end of colonialism in his country. As he explained, it was his goal as a Moroccan filmmaker “to get audiences used to seeing themselves and their own problems on the screen, and from that, to be able to judge themselves and the society in which they live” (Bouanani, 1990/2018, p. 27). In other words, through his work, he was dedicated to presenting the lived reality of Moroccans navigating their world in a post-colonial society; The Hospital, Bouanani’s first-person account of his six-month-long stay in the Moulay Youssef Hospital in Rabat, is no different. In contrast, João Biehl’s novel titled Vita: Life in a Zone of Social Abandonment is not a first-person account but rather an ethnographic study, following the life of Catarina as she navigates the institutional space of Vita, an asylum located in Porto Alegre, Brazil. While the narrative styles of Biehl and Bouanani differ greatly, both works focus on a specific medical institution, exploring how that space is shaped by politics and memories, both factors that come to bear on the medical experience of those who inhabit the space.
Both Biehl’s and Bouanani’s accounts reveal how the clinical spaces in their texts are inextricably linked to the wider social and political contexts of the time. It is these wider contexts that create, in these settings, what Biehl (2013) calls “death-in-life” (p. 38). According to Biehl, Vita can be defined as a zone of social abandonment: a place where society discards its unwanted members, “living beings… [who] are no longer considered people” (p. 2). Through his study of Catarina, he demonstrates how Brazil’s changing political and economic situation has created conditions that deem the abandonment of specific individuals as necessary and, therefore, acceptable. Catarina, Biehl maintains, “was caught in a period of political and cultural transition” (p. 21), a transition that emphasized the divide “between the “market-able” and the socially excluded” (p. 21). This transition ultimately labeled people like Catarina as defective and unproductive and, thus, authorized their expulsion to Vita (p. 20). Thus, Biehl highlights how the changing socio-political landscape comes to bear on medical experience by sanctioning the rejection of specific individuals from society, leaving them for dead. It is this shifting socio-political context that leads individuals to be “separated from their normal political status and abandoned to the most extreme misfortune, death-in-life” (Biehl, 2013, p. 38), a state where someone’s body keeps on living, but their personhood has been violently ripped away. This experience of death-in-life seems to be characteristic of Vita, where Catarina and other residents struggle to simply make it through another day. In sum, Biehl’s work emphasizes how medical experience is deeply enmeshed in the social and political, with these factors shaping almost every part of Catarina’s journey to and experience in Vita.
Likewise, The Hospital presents a similar situation. As explained in the introduction, Bouanani grew up amid socio-political uproar as nationalist fights for independence from the French colonial regime reached their peak. Even when Morocco finally gained independence, the turmoil in the country continued. In fact, when Bouanani was admitted to the hospital in 1967, Morocco was once again in a state of political unrest under the repressive regime of Hassan II (Bouanani, 1990/2018, pp. 15-16). This tumultuous political history repeatedly comes to the fore in Bouanani’s narrative; it marks the lives of the patients in the hospital, shaping their medical experience. As “rejects of inexplicable wars and an aborted nationalist resistance” (Bouanani, 1990/2018, p. 47), Bouanani’s fellow residents of Wing C are well aware of their situation, repeatedly drawing attention to how the political and social unrest in their country has stained the fabric of their lives, leaving no other option for them but “the back-and-forth hospital cycle” (Bouanani, 1990/2018, p. 70). In one of his many conversations with Bouanani, Guzzler, a recurring figure, explains the cycle from his point of view:
‘Guys like us don’t get better!…They resuscitate our small miserable spark of life just
enough that people don’t quite mistake us for human beings.…[W]e go back to our
daily bullshit, we try to return to the thick of things, we slip, we fall flat on our faces on
the sidewalk, it’s always too late to start living, always…’ (Bouanani, 1990/2018, p. 67)
In this exposition, Guzzler illustrates how many of the hospital residents get stuck in a cycle: whether they are fleeing from overcrowded slums (Bouanani, 1990/2018, p. 55) or escaping the disintegration of their past lives (Bouanani, 1990/2018, p. 107), the residents always end up back at the hospital; the hospital becomes their home (Bouanani, 1990/2018, p. 57). Just like Catarina in Biehl’s text, the characters in Bouanani’s work are rendered as not quite human due to the societal and political contexts they are caught in, and, deprived of their personhood, the hospital becomes the only place left for them. By claiming that it is too late to start living, Guzzler seems to imply that he is already dead. It is in this way that the hospital becomes “an odd cemetery [with] residents [who] live above the graves” (p. 97). In short, with no other future but the hospital itself—a result of the social and political conditions of the time—Bouanani’s fellow residents are condemned to death-in-life.
As both Biehl and Bouanani demonstrate, memories become central to the figures in their work, as remembering becomes a form of agency against the death-in-life fate that the residents face in the clinical spaces of Vita and the hospital. As Biehl describes, during his time with Catarina, she repeatedly discussed her life from before, ruminating and reflecting on the events that led to her exile at Vita. However, in doing so, Catarina was not just trying to make sense of her situation, but rather, “[b]y going through all the components and singularities of these events, she was resuming her place in them” (Biehl, 2013, p. 18). By recounting her memories, Catarina, as Biehl declares, was “demand[ing] one more chance in life” (18). In other words, remembering was an act of agency for Catarina. As someone deemed less-than-human, prevented from full access to personhood and subjectivity, Catarina found a way to reassert her humanity through her memories. The memories themselves transformed Catarina into a complete, subjective human being with a past and, therefore, a future, thus rejecting her fate of death-in-life. In sum, remembering allowed Catarina to assert some agency over her own medical experience.
In the same way, memories become central to Bouanani as a way to navigate his own medical experience. Throughout his narrative, time and time again, Bouanani (1990/2018) calls attention to his memories, often of his childhood, a life he calls his “youthful corpse” (p. 69). While searching through these memories, there are moments when Bouanani questions their purpose. For instance, in a moment of frustration and sorrow following the death of the old man, Bouanani writes, asking “[w]hy…[he] need[s] the memories of rotting, human wrecks, the shambles of the year of [his] birth, a 1938 populated by the damned” (p. 45). Ultimately, Bouanani comes to a conclusion through his narrative: his memories help hold him together. Just as Catarina’s memories thread her experience together, allowing her to assert her full, complex personhood, Bouanani’s memories serve the same purpose. Upon realizing that the hospital has stripped him of even his memories, Bouanani wakes “with frightening feelings…of being torn apart, of no longer being guided by a logical thread” (p. 109). In this way, Bouanani recognizes that his memories keep him sane as he faces the hospital experience. As he writes, it is this repetition of his memories, playing on a loop repeatedly in his mind, through “which [he] struggle[s] to put [himself] back together” (40), but he is putting himself back together, nonetheless. Thus, remembering also becomes an act of agency for Bouanani, protecting him against the languishing and deadly forces of the hospital as he constantly reasserts and reminds himself of his humanity through his memories.
As Biehl and Bouanani illustrate, medical settings are never separate from the politics of a time and place. Socio-political factors come to bear on medical experience, shaping its very nature. In both texts, Brazil’s and Morocco’s social and political conditions constructed a conception of humanity that excluded people like Catarina and Guzzler, leaving no place left for them in society and condemning them to life in either Vita or the hospital. As a result, the medical experience of the residents of Vita and the hospital becomes one of death-in-life. Nonetheless, both works still reveal how acts of agency find their way into these clinical spaces, specifically through the effort of remembering. In fact, for both Bouanani and Catarina, their memories become a powerful way to challenge their supposed fate of death-in-life, reinstating their humanity that both the medical space itself and the wider socio-political conditions had stripped away. In short, both Biehl and Bouanani exemplify the ways in which politics and memories can shape medical experience.
References
Biehl, J. (2013). Vita: Life in a Zone of Social Abandonment. University of California Press. https://ebookcentral.proquest.com/lib/mcgill/detail.action?docID=1433262
Bouanani, A. (2018). The Hospital. (L. Vergnaud, Trans.). New Directions Publishing. (Original work published 1990)
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